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Petition for Network/Chapter Charter Form
Date of Petition: ____________________________________________
Proposed Name of Network/Chapter: ____________________________
Type (Geographic, Affinity, Affinity, Corporate): ____________________
Chair Name: _________________; Assistant Chair Name:_____________
(a Profile and Acknowledgement of Responsibilities is attached)
Roster:
1. _______________________
2._______________________
3. _______________________
4. _______________________
5._______________________
6. _______________________(for a Network)
7._______________________
8._______________________
9._______________________
10. _______________________
11._______________________
12._______________________
13._______________________
14._______________________
15._______________________
16._______________________
17_______________________
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18._______________________
19._______________________
20._______________________
21._______________________
22._______________________
23._______________________
24._______________________
25.___________________(for a chapter)